Is Portal Vein Thrombosis Life Threatening?
Portal vein thrombosis ( PVT ) is the narrowing or blockage of portal venous blood vessel by a thrombus or lineage coagulum . Portal vena is the blood vessel that carries blood from intestines to liver and a thrombus cuts this blood supply . In most typeface , the portal nervure thrombosis is a treatable consideration , but in cases of acuate thrombosis , it can become living threatening and might lead to intestinal ischemia and/or infarct that require immediate treatment .
Portal vein thrombosis can be caused due to either reduced flow of blood or portal hypertension , endothelial perturbation or hypercoagulable state . The most coarse campaign of PVT is cirrhosis of the liver and about 1/4 patients with cirrhosis have a inclination to develop thrombosis due to severe scarring of liver . Other causes admit hepatocelllular carcinoma , cholangiocarcinoma , stomachic carcinoma , pancreatic ductal carcinoma , ague pancreatitis , chronic constrictive pericarditis , chronic gist unsuccessful person , Budd - Chiari syndrome , polycythemia vera , appendicitis , abdominal surgery , ascend cholangitis , umbilicus ( umbilicus ) infection in newborns , antiphospholipid syndrome , dehydration , inflammatory gut disease , myeloproliferative disorderliness , unwritten contraceptive pills , pregnancy and/or trauma .
Symptoms of Portal Vein Thrombosis
Portal vein thrombosis is the most vernacular crusade of portal hypertension . A portal nervure thrombus can be either a politic thrombus or a tumour ( malignant ) thrombus . Most of the times , PVT is asymptomatic and in minor thrombus will present with symptoms of fever , upper abdominal pain , and abdominal gibbosity due to undue abdominal fluid accumulation . In austere coagulum , there might be splenomegaly with the ontogeny of portal high blood pressure and symptoms include esophageal varices and gastric haemorrhage , fever , and chills , vomitingof blood , pain in the liver ( in the right upper quadrant),jaundiceand tarry , bloody and foul sense stools .
Diagnosis of Portal Vein Thrombosis
The diagnosis of portal mineral vein thrombosis is done with the assistant of medical history and a combination of signs and symptoms of blown-up quick temper , haematemesis , variceal bleeding and liver contagion . Liver function tests are done to check the functionality of liver , but in PVT they are generally normal . Imaging include ultrasonography , CT scan , MRI and angiography is done for the definite diagnosis of portal venous blood vessel thrombosis .
Doppler ultrasound uses effectual waving for the detection of blood rate of flow within the vessel and can be used to diagnose portal vein thrombosis and its hardness . In subject of PVT , it exhibit reduced / scatty rip flow through portal veins .
CT scanusesX - raysfor demarcation of off-white and blood vas and a dyestuff is injected in nervure for the identification of parentage clot .
MRIof abdominal cavity uses attractor and radio wave , which is used for the designation of blood stream and circulation irregularity , peck in various abdominal organs and abdominal swelling .
Angiography is an encroaching trial run that uses X - rays and shot of a special dye for the product of prototype of blood flow / circulation within a vena or an artery and for the identification of blood coagulum .
Treatment of Portal Vein Thrombosis
The treatment of portal vein thrombosis reckon on the primary causal agency of it and aim at dissolve the clot or bar of gradual thrombus growth over time . The clot is dissolved through thrombolysis with the aid of plasminogen activator and to prevent thrombus growing or return , anticoagulants such as Lipo-Hepin are used .
In cases of umbilicus infection or appendicitis , antibiotics are used to crystalize the infection and PVT too .
The treatment is also aimed at lower the symptoms of portal vein pressure and bar of esophageal varicose bleed . antihypertensive drug such as beta - blockers and nitrates are used to thin portal vein pressure ; octreotide is used to lose weight the blood flow to the liver , thus reduce press in the portal vein . The reduced descent press in the portal mineral vein also shorten the chance of esophageal varicose bleeding . Banding of esophageal varicose vein is also undertaken to prevent bleeding of variceal veins . bypass surgery is used as a last hangout for the prevention of supernumerary haemorrhage and pressure diminution in veins . Some cases of the liver damage might also want liver transplant .
Also show :
